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Are we appropriately selecting therapy for patients with cervical cancer? Longitudinal patterns-of-care analysis for stage IB-IIB cervical cancer
- Source :
- International journal of radiation oncology, biology, physics. 90(4)
- Publication Year :
- 2014
-
Abstract
- Purpose We performed a patterns-of-care analysis evaluating the effects of newer technology and recent research findings on treatment decisions over 26 years to determine whether patients with cervical cancer are being appropriately selected for treatment to optimize the therapeutic ratio. Methods and Materials A retrospective analysis was conducted using the Surveillance, Epidemiology and End Results (SEER) program from 1983 to 2009. We identified 10,933 women with stage IB-IIB cervical carcinoma. Results Of the 10,933 subjects identified, 40.1% received surgery, 26.8% received radiation (RT), and 33.1% received surgery plus RT. RT use increased after 2000 compared to prior to 2000, with a corresponding decrease in surgery and surgery plus RT. Among patients with risk factors including tumor size >4 cm, positive parametria, and positive lymph nodes, declining use of surgery plus RT was observed. However, 23% of patients with tumors >4 cm, 20% of patients with positive parametria, and 55% of node-positive patients continued to receive surgery plus RT as of 2009. Factors associated with increased use of surgery plus RT included patient age Conclusions In this largest patterns-of-care analysis to date for patients with locally advanced cervical cancer, we found a substantial proportion of patients continue to undergo surgery followed by radiation, despite randomized data supporting the use of definitive radiation therapy, with lower morbidity than surgery and radiation.
- Subjects :
- Adult
Cancer Research
medicine.medical_specialty
Medical surveillance
medicine.medical_treatment
Uterine Cervical Neoplasms
Stage ib
Epidemiology
Carcinoma
Medicine
Humans
Radiology, Nuclear Medicine and imaging
Stage (cooking)
Aged
Neoplasm Staging
Retrospective Studies
Cervical cancer
Radiation
business.industry
Retrospective cohort study
Middle Aged
medicine.disease
Combined Modality Therapy
Surgery
Tumor Burden
Radiation therapy
Oncology
Carcinoma, Squamous Cell
Regression Analysis
Female
business
SEER Program
Subjects
Details
- ISSN :
- 1879355X
- Volume :
- 90
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- International journal of radiation oncology, biology, physics
- Accession number :
- edsair.doi.dedup.....2b6cce9fbb490935ed13ecad52f4f78c